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Heart palpitations and ectopic beats
Heart palpitations are heartbeats that suddenly become more noticeable.
Your heart may feel like it's pounding, fluttering or beating irregularly, often for just a few seconds or minutes. You may also feel these sensations in your throat or neck.
Palpitations may seem alarming, but in most cases they're harmless and are not a sign of a serious problem.
Sometimes you may feel an extra or missed beat. These are known as ectopic beats and are also usually nothing to worry about.
Causes of heart palpitations
Causes of heart palpitations include:
lifestyle triggers
emotions and psychological triggers
medicines
hormone changes
heart rhythm problems
heart conditions
other medical conditions
Lifestyle triggers
Common triggers of heart palpitations include:
strenuous exercise
not getting enough sleep
drinks containing caffeine, such as coffee, tea and energy drinks
alcohol
smoking
illegal drugs, such as cocaine, heroin, amphetamines, ecstasy and cannabis
rich or spicy foods
In these cases, the palpitations should go away on their own. Avoiding these triggers may help stop them from coming back.
Emotional or psychological triggers
Heart palpitations are also often caused by emotions or psychological issues, such as:
excitement or nervousness
stress or anxiety
panic attacks – an overwhelming sense of anxiety or fear, accompanied by feeling sick, sweating, trembling and palpitations
Doing breathing exercises and learning how to deal with a panic attack may help if you're feeling stressed, anxious or panicked.
Medicines
Palpitations can occasionally be triggered by some medicines, including:
asthma inhalers, such as salbutamol and ipratropium bromide
high blood pressure (hypertension) medicines, such as hydralazine and minoxidil
antihistamines, such as terfenadine
antibiotics, such as clarithromycin and erythromycin
antidepressants, such as citalopram and escitalopram
antifungal medicines, such as itraconazole
Speak to a GP if you think a medicine may be causing your heart palpitations. But do not stop taking a prescribed treatment without first getting medical advice.
Hormone changes
Heart palpitations in women can sometimes be the result of hormonal changes that happen during:
periods
pregnancy
the menopause 
In these cases, the palpitations are usually temporary and not a cause for concern.
Heart rhythm problems
Palpitations are sometimes caused by a problem with the heart rhythm (arrhythmia), such as:
atrial fibrillation – this is the most common type, where the heart beats irregularly and faster than normal
atrial flutter – a fast and irregular heartbeat
supraventricular tachycardia (SVT) – abnormally fast heart rate
ventricular tachycardia – a more serious condition where the regular heartbeat is typically fast. It can be associated with dizziness or blackouts
Heart conditions
Some palpitations may be associated with other types of heart conditions, such as:
a problem with the heart valves, such as mitral valve prolapse
hypertrophic cardiomyopathy – where the heart muscle and walls of the heart become enlarged and thickened
heart failure – where the heart is unable to pump blood around the body properly
congenital heart disease – birth defects that affect the normal workings of the heart
Some of these conditions can be serious and often require treatment.
Other medical conditions
Other conditions that can cause heart palpitations include:
an overactive thyroid (hyperthyroidism) – where the thyroid gland produces too much of the thyroid hormones
a low blood sugar level (hypoglycaemia) – this is most commonly associated with diabetes
types of anaemia, which affects the red blood cells
postural or orthostatic hypotension – dizziness and low blood pressure triggered by changing position (such as standing up)
a high temperature
dehydration
When to see a GP
You do not usually need to see a GP if the palpitations pass quickly and only happen occasionally. They're unlikely to be caused by a serious problem and probably will not need treatment.
But it's a good idea to see a GP if:
the palpitations last a long time, do not improve or get worse
you have a history of heart problems
you're concerned about the palpitations
To help find the cause, a GP may:
ask about your symptoms and medical history
arrange a blood test
carry out an electrocardiogram (ECG) to check your heart rate (if the GP has the equipment available)
If you cannot have an ECG at the GP surgery or the GP wants to arrange heart monitoring over a longer time period, you may be referred for tests at a local hospital.
When to get emergency help
Call 999 for an ambulance or go to your nearest A&E if you have heart palpitations and any of the following symptoms:
severe shortness of breath
chest pain or tightness
dizziness or light-headedness
fainting or blackouts
These symptoms could indicate a serious or potentially life-threatening heart problem that should be checked by a doctor straight away.
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Page last reviewed: 24 October 2019
Next review due: 24 October 2022
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